Fitness questions and answers for July 18, 2005

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Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at fitness@cyclingnews.com. Please include as much information about yourself as possible, including your age, sex, and type of racing or riding. Due to the volume of questions we receive, we regret that we are unable to answer them all.

Carrie Cheadle, MA (www.carriecheadle.com) is a Sports Psychology consultant who has dedicated her career to helping athletes of all ages and abilities perform to their potential. Carrie specialises in working with cyclists, in disciplines ranging from track racing to mountain biking. She holds a bachelors degree in Psychology from Sonoma State University as well as a masters degree in Sport Psychology from John F. Kennedy University.

Dave Palese (www.davepalese.com) is a USA Cycling licensed coach and masters' class road racer with 16 years' race experience. He coaches racers and riders of all abilities from his home in southern Maine, USA, where he lives with his wife Sheryl, daughter Molly, and two cats, Miranda and Mu-Mu.

Kelby Bethards, MD received a Bachelor of Science in Electrical Engineering from Iowa State University (1994) before obtaining an M.D. from the University of Iowa College of Medicine in 2000. Has been a racing cyclist 'on and off' for 20 years, and when time allows, he races Cat 3 and 35+. He is a team physician for two local Ft Collins, CO, teams, and currently works Family Practice in multiple settings: rural, urgent care, inpatient and the like.

Fiona Lockhart (www.trainright.com) is a USA Cycling Expert Coach, and holds certifications from USA Weightlifting (Sports Performance Coach), the National Strength and Conditioning Association (Certified Strength and Conditioning Coach), and the National Academy for Sports Nutrition (Primary Sports Nutritionist). She is the Sports Science Editor for Carmichael Training Systems, and has been working in the strength and conditioning and endurance sports fields for over 10 years; she's also a competitive mountain biker.

Eddie Monnier (www.velo-fit.com) is a USA Cycling certified Elite Coach and a Category II racer. He holds undergraduate degrees in anthropology (with departmental honors) and philosophy from Emory University and an MBA from The Wharton School of Business.

Eddie is a proponent of training with power. He coaches cyclists (track, road and mountain bike) of all abilities and with wide ranging goals (with and without power meters). He uses internet tools to coach riders from any geography.

David Fleckenstein, MPT (www.physiopt.com) is a physical therapist practicing in Boise, ID. His clients have included World and U.S. champions, Olympic athletes and numerous professional athletes. He received his B.S. in Biology/Genetics from Penn State and his Master's degree in Physical Therapy from Emory University. He specializes in manual medicine treatment and specific retraining of spine and joint stabilization musculature. He is a former Cat I road racer and Expert mountain biker.

Since 1986 Steve Hogg (www.cyclefitcentre.com) has owned and operated Pedal Pushers, a cycle shop specialising in rider positioning and custom bicycles. In that time he has positioned riders from all cycling disciplines and of all levels of ability with every concievable cycling problem.They include World and National champions at one end of the performance spectrum to amputees and people with disabilities at the other end.

Current riders that Steve has positioned include Davitamon-Lotto's Nick Gates, Discovery's Hayden Roulston, National Road Series champion, Jessica Ridder and National and State Time Trial champion, Peter Milostic.

Pamela Hinton has a bachelor's degree in Molecular Biology and a doctoral degree in Nutritional Sciences, both from the University of Wisconsin-Madison. She did postdoctoral training at Cornell University and is now an assistant professor of Nutritional Sciences at the University of Missouri-Columbia where she studies the effects of iron deficiency on adaptations to endurance training and the consequences of exercise-associated changes in menstrual function on bone health.

Pam was an All-American in track while at the UW. She started cycling competitively in 2003 and is the defending Missouri State Road Champion. Pam writes a nutrition column for Giana Roberge's Team Speed Queen Newsletter.

Dario Fredrick (www.wholeathlete.com) is an exercise physiologist and head coach for Whole Athlete™. He is a former category 1 & semi-pro MTB racer. Dario holds a masters degree in exercise science and a bachelors in sport psychology.

Scott Saifer (www.wenzelcoaching.com) has a Masters Degree in exercise physiology and sports psychology and has personally coached over 300 athletes of all levels in his 10 years of coaching with Wenzel Coaching.

Kendra Wenzel (www.wenzelcoaching.com) is a head coach with Wenzel Coaching with 17 years of racing and coaching experience and is coauthor of the book Bike Racing 101.

Steve Owens (www.coloradopremiertraining.com) is a USA Cycling certified coach, exercise physiologist and owner of Colorado Premier Training. Steve has worked with both the United States Olympic Committee and Guatemalan Olympic Committee as an Exercise Physiologist. He holds a B.S. in Exercise & Sports Science and currently works with multiple national champions, professionals and World Cup level cyclists.

Through his highly customized online training format, Steve and his handpicked team of coaches at Colorado Premier Training work with cyclists and multisport athletes around the world.

Brett Aitken (www.cycle2max.com) is a Sydney Olympic gold medalist. Born in Adelaide, Australia in 1971, Brett got into cycling through the cult sport of cycle speedway before crossing over into road and track racing. Since winning Olympic gold in the Madison with Scott McGrory, Brett has been working on his coaching business and his www.cycle2max.com website.

Richard Stern (www.cyclecoach.com) is Head Coach of Richard Stern Training, a Level 3 Coach with the Association of British Cycling Coaches, a Sports Scientist, and a writer. He has been professionally coaching cyclists and triathletes since 1998 at all levels from professional to recreational. He is a leading expert in coaching with power output and all power meters. Richard has been a competitive cyclist for 20 years

Andy Bloomer (www.cyclecoach.com) is an Associate Coach and sport scientist with Richard Stern Training. He is a member of the Association of British Cycling Coaches (ABCC) and a member of the British Association of Sport and Exercise Sciences (BASES). In his role as Exercise Physiologist at Staffordshire University Sports Performance Centre, he has conducted physiological testing and offered training and coaching advice to athletes from all sports for the past 4 years. Andy has been a competitive cyclist for many years.

Michael Smartt (www.cyclecoach.com) is an Associate Coach with Richard Stern Training. He holds a Masters degree in exercise physiology and is USA Cycling Expert Coach. Michael has been a competitive cyclist for over 10 years and has experience coaching road and off-road cyclists, triathletes and Paralympians.

Kim Morrow (www.elitefitcoach.com) has competed as a Professional Cyclist and Triathlete, is a certified USA Cycling Elite Coach, a 4-time U.S. Masters National Road Race Champion, and a Fitness Professional.

Her coaching group, eliteFITcoach, is based out of the Southeastern United States, although they coach athletes across North America. Kim also owns MyEnduranceCoach.com, a resource for cyclists, multisport athletes & endurance coaches around the globe, specializing in helping cycling and multisport athletes find a coach.

Advice presented in Cyclingnews' fitness pages is provided for educational purposes only and is not intended to be specific advice for individual athletes. If you follow the educational information found on Cyclingnews, you do so at your own risk. You should consult with your physician before beginning any exercise program.

Crankarm length
Speedplay roll float
Lower back pain
Hip pain and IT band tightness
Saddle sores
Possible sit height issue
Pain only in recommended fit range
Racing after a broken hip/leg
Stretching
Type II diabetes question
Upper calf/lower hamstring pain

Crankarm length

Steve,

I wanted to thank you for your advice given freely in your columns. You're passionate about your work which shows through in your well thought responses. I have (over the past 5-6 months) adjusted my cleats and position slightly according to your suggestions. It's interesting to note when viewing in a mirror (standing) my hip line is pretty even now, post adjustments. Before, my left hip was noticeably elevated and forward and off the bike I experienced a constant throb in my gluteus medius. Also, my quadriceps was over developed with an underdeveloped gluteus region. Through your adjustment suggestions, stretching and remaining properly hydrated, I am now relatively pain free.

I still am playing with the cleat position and have a question that is probably obvious to you but perplexing to me. I have different placement of my metatarsals due to different insteps in each foot. I assume this is the reason for the difference in length in each of the feet. My question- why not take the measurement from the ankle bone?

Wouldn't this properly line up the knee and pelvis better than using behind the 1st metatarsal of different length feet?

My next question is concerning crankarm length. I have a 74cm inseam and switched to 165 crankarms about 1.5 years ago because I was experiencing difficulty getting on top of the gears on the climbs. I am looking at upgrading to 10 and after four years of cleaning and taking care of my Ultegra and my husband's Chorus 10, there is no comparison in quality. (His Campy, I think, looks better than when he bought it, if that's possible!) The two issues - my little hands on Campy levers may have a problem wrapping around comfortably for thumb reach, and crank arm length. They do not carry 165's. I am thinking with my cleat position corrected I may me ok on the 170's.

My question is how long should I give this to experience if this is a good move and how will my body react if this is a bad move? I may add, my body will react negatively with 1-2cm off any of my measurements so I will initially go through pain, I'm sure. It's after that -what should I be looking for? Perhaps I should wait to try this experiment in winter after racing is done? Any thoughts are appreciated. Thank you!

Erica

Steve Hogg replies

I have thought in the past about what you are saying, but there are a few practical problems in measuring from either malleolus [the bumps on the side of the ankle] or the heel. Firstly, the plantar fascia, which is a flat tendon-type structure, attaches to the rear of the foot and the metatarsal joints. The type of cleat positioning I advocate reduces stress on this as well as having a pronounced effect on the musculature enlisted further up the chain.

Briefly, if there is enough foot over the pedal, ankle movement is limited to a degree that can be well and easily controlled by the calves. This in turn means that the calves can get on with what I think is their real job on a road or tri bike, which is to contract eccentrically in concert with the hamstrings doing the same during the pedal downstroke. Both calves and hammies cross the knee joint. Working together eccentrically, the net effect is to pull the knee backwards.

What that in turn means is that as well as the quads working hard to extend [straighten] the knee on the pedal downstroke, this second extensory mechanism is also at work PROVIDING cleat and seat position are ok. This, as you have found, spreads the load over a much larger amount of musculature and because of where the quads and hammies attach, can aid pelvic stability on a bike seat.

If as in your case, someone with differing foot sizes measures their cleat position from the heel, they will have pedalling mechanics that may be grossly different on each side. This may have a negative effect more than their legs. Experience has taught that the best option in such cases is to get the cleat position right for each foot separately, and if foot size is noticeable different and assuming that there are no other complicating factors, to be prepared to place a shim under the cleat of the short foot so as to gain even extension of both legs at knee, hip and ankle.

As to why I choose to measure cleat placement relative to first metatarsal; merely convention. Any publication I have read does this and continuing that method makes it easier for people to understand. Any cleat placement posts I have posted are approximate and are unlikely to do anyone any harm if followed. If I was positioning someone in person, I may depart from the posts slightly because of other factors.

In relation to crank length and swapping groups - for your 74cm inseam, even 165mm is a long crank. Much as I agree that Campag is generally better made, the Shimano 10 speed levers are a better bet for what are likely to be your small hands and fingers. Given the history of problems that you imply, I would stick to the crank length that you have already. I would get a pair of Deda anatomic bars in whatever width is appropriate. Deda measure outside edge to outside edge with the bar sizing and make down to a 38 cm outside to outside [35.5cm centre to centre]. They are technically a deep drop bar with a medium reach, but the radius of the bend is quite open compared to a lot of anatomic bars as well as being situated relatively high in the total drop. What this means is that combined with Shimano 10 speed STI levers, you are more likely to be able to get the brake hoods at a comfortable height so as they can be held without a pronounced bend of the wrist while still being able to reach the brake levers from the drops.

The only negative with the Deda anatomic bars are the sharp corner where the anatomic section meets the flat section at the bottom. This is right where the hand grips the bar in a sprint or off the seat effort and this shape doesn't allow the bar to fill the hand well. Two or three layers of bar tape in decreasing lengths place atop each other on that corner will feel a lot better when the bar is taped with that in place. If using the Deda anatomic bar, position it so that the rearmost portion of the drops is horizontal.

I don't know you and can't see you, but purely on the inseam measurement that you have, I would not advise going to longer cranks and would advise from an ergonomic point of view that you are probably better served by Shimano 10 speed bits than Campag given your size.

Speedplay roll float

I am curious about the effect of "roll" float (of the pitch, roll, and yaw definitions used in aerospace http://www.bmfa.org/faq/flight_controls.htm) on knees.

I have Speedplay X-2 pedals, and notice that they allow my knee to move toward the top tube and away from the top tube, while maintaining alignment with my calf and ankle. I can feel the cleat/pedal interface allowing this movement, it is not just my foot moving in the shoe or my ankle flexing left and right. This seems different than I remember from riding Looks two years ago.

My knees are bothering me on and off more this year, and I have a problem with a very tight "string" of muscle in the outer portion of both calves (Fibularis, Soleus, or Tibalis anterior muscle). I wonder if the pedal's roll allowance encourages a misalignment in the knee/pedal relationship, perhaps causing me to overuse the outer part of the calf.

Also, I have a tightness in the back of my left knee that usually goes away early in rides. It sometimes bothers my hiking or walking up stairs. When I pedal, or sometimes when I walk up stairs, it feels like a tendon is mildly "snapping over" something. If I feel around behind both bent knees, I can feel a tendon or ligament in the left that is more prominent than the right. When they are extended, the left is slightly tender. Could it be the Biceps Femoris Tendon? Since it connects to the Tibalis anterior, maybe it relates to the tightness in the calves? Thank you for your previous assistance.

Wayne Maceyka

Steve Hogg replies

Speedplays are generally a good pedal system but are handicapped somewhat by having a lesser ability to adjust the cleat fore and aft than many other systems. You mention that your feet move around more in your Speedplays than in previous Looks. Depending on the model of Look pedals that you had and the model and brand of shoe that you have [had?], the quality of the rotational movement in Looks can vary from quite free to quite stiff. By stiff I mean that rotational movement is possible but if the rubber plug on the cleat bottom protrudes a lot, then it can take a small but noticeable effort for the cleat to move rotationally. Compared to this, Speedplays have a 'free' quality to their rotational movement. Rest assured your feet are moving around because some combination of position, your own morphology and cleat placement dictates this.

It is also possible that the cleat placement fore and aft on your shoes differs between your Look cleats and Speedplay cleats. If this is the case and your Speedplays don't allow you enough foot over the pedal, any problems that you have structurally and functionally are likely to be exacerbated.

What you term "roll" float is also present in Look pedals and becomes pronounced as the cleat is worn down from walking. As the cleat becomes thinner through wear, there is vertical slop and there can be "roll" float if the mechanics of the rider dictate this.
If I had to guess at the reason or reasons for the increased degree of knee problems you are experiencing this year I would look at the following:

1. Have a look at this post and this post, and position your cleats like that. That should minimise your problems or at least eliminate cleat position as a variable.

2. From what you say, you are overextending the left leg. You need to find out whether there is a measurable difference in leg length or whether you are sitting asymmetrically on the seat. As far as leg length goes, the only definitive way is to have an X-ray taken from the waist down while standing with bone lengths measured between joint centres. The quick way to determine how square you are sitting is to look down between your thighs and see whether the gap between inner thigh and seatpost differs between legs. If the gap is larger between left inner thigh and seatpost, you can bet that you are hanging to the right or rotating forward to the right on each right leg pedal stroke. This causes the left leg to reach further than the right and also causes the left leg to move laterally to varying degrees to accommodate the right hip drop.

If you have big thighs and there is no gap between inner thigh and seatpost, have an observer stand above and just behind you while you pedal on a trainer under reasonable load with your shirt off. It should be obvious to the observer which side if any you favour.
Once you have had the X-ray and checked your squareness on the seat, get back to me with what you found and we'll proceed from there.

Lower back pain

I am a 48 year old who has been cycling for 10 years. Over the years I have moved my saddle nose back from 3cm behind BB to 7.5cm (kops for me). I still think I have too much weight on my hands to be comfy on long rides so I tried 9.5cm and adjusted the bars back for proper reach. It was amazing how good it felt! It's relaxed in any bar position and there's no weight on my hands for a good natural spin.

And it provides a good aero position with a 2cm handlebar drop. But the price to pay was lower back pain when I tried to push a little harder. Is this a question of putting in the miles in low gears until my back gets stronger or have I passed some limit on advisable saddle setback.

Erik Westergren

Steve Hogg replies

It is a bit hard to be specific without knowing a lot more about you. How flexible are you? You say that your seat is 20mm below the seat which implies that you are not particularly flexible. Is this correct?

If you are tight in the hip flexors, particularly the psoas, moving your seat too far back without a rise in bar height will cause them to work harder than they like under load. The psoas attaches to the five lumbar vertebrae and lowest thoracic vertebrae and this is the likely reason that your back hurts. That said, given the extent of the change from 30mm behind the bottom bracket centre to 95mm behind, how long did you give your body to adjust with low to moderate intensity riding?
If I made changes of that magnitude [and I have] I would strongly advise the rider to ride only flat to undulating terrain at E1 and no higher than E2 if they have to get up the occasional hill, for a minimum of 3-4 weeks post-change.

Give yourself some low intensity kilometres for a few weeks and then introduce some harder stuff. If the pain returns I would either raise the bars slightly or perhaps move the seat forward 5mm and reassess.
As to whether you have passed some inherent limit of setback, it is impossible to say without seeing you. 95mm is too far back for many and not far enough back for others.

Hip pain and IT band tightness

Steve, saw your recent post on Ischeal tuberosity pain and I have a similar issue, but mine is mostly outside hip pain and IT band tightness on just my left side. While pedaling and looking down between my legs my right leg comes much closer to rubbing the seat tube. Does this mean left leg or right left is longer? Or neither, and it's something else? Thanks.

Lynn Neir

Steve Hogg replies

The right leg coming closer to the seatpost than the left indicates that you are hanging to the right to some degree. The answer to the question why this is so has a lot of potential answers.

1. It could indeed mean that you have a long right leg. A common adaptation to a long leg [but not the only one] over a lifetime, is to have a right iliac crest that is anterior to the left. The iliac crest moves forward because you exert more torque at the hip with the longer leg. As this happens the hip which is below the centreline of the ilium moves up and back, typically about 3mm for every 5mm that the iliac crest moves forward. Autonomically you will do whatever it takes to square up the hips which means twisting the right one forward.

2. It could have nothing to do with leg length differences and just mean that you are tighter in the hip flexors [and probably elsewhere] on the right side. If you take up Pilates, yoga or something similar, this will resolve the problem for most people in time.

3. You may have a pronounced uncompensated right forefoot varus which is not present to anything like the same degree on the left. The number of people like this that I see astounds me. A forefoot varus is a twist through the mid foot meaning that under no load, the forefoot rolls inwards towards the big toe relative to the rear foot. Theoretically this should cause lateral or rotational loads on the knee when pedalling, but a lot of people's autonomic compensatory mechanism is to internally rotate the entire hip which keeps the knee tracking reasonably well, but tends to cause the hip to be dragged forward on the seat.

4. The least likely reason, though I see more than a few, is that your left brain hemisphere is so dominant relative to the right, that asymmetric postural changes are the fallout.

If you want to get on top of this, find a good structural health professional, show him your question and this reply and ask them whether they can assess you and prescribe a solution based on what they find. If this option is not open to you, start stretching a lot or take up yoga or pilates.

Saddle sores

Hello,

Recently you suggested using 'triple antibiotic' for saddle sores - could you please tell me if this is a cream or tablet and is it available 'over the counter' or do I require a prescription for it? Thanks

Chris

Scott Saifer replies

Hi Chris,

Triple antibiotic is available over the counter in most supermarkets and drug stores. It's available as a cream or a gel, comes in a tube and is not expensive. It works well on sores with broken skin. Neosporin is a common brand.

If there is a hard pea-sized lump under the skin, try a drawing salve, also available OTC in drug stores and supermarkets. If there is a lump larger than a pea or if the lump is not in the saddle-contact area of your body, consult your physician.

Possible sit height issue

I am 37 and a casual rider who is trying to work myself into a more competitive athlete. I am noticing some slight right knee pain at the bottom of the joint where the tendon attaches to the bone. This occurs after my more aggressive training rides.

Is this a sit height issue, an over exertion issue, or a cadence mechanics issue? Thanks for your help!

Terry Daley

Steve Hogg replies

Is the pain occurring on one side only as I suspect?
If so, the most common cause is either a short leg or not sitting square on the seat. If there is a measurable leg length discrepancy or, a common compensatory mechanism is to sit with the hip of the longer leg further forward on the seat. This means that the longer leg is actually closer to the pedals than the shorter leg. If the seat height is comfortable for the short leg then the other will under extend and niggles where you have them is not uncommon.
If you don't have a measurable leg length discrepancy but sit twisted on the seat for other reasons, the result can be the same as the leg on the side that is twisted further forward reaches less far.
Here is a test: . Pedal under reasonable load and look at the gap between inner thigh and seatpost. If the gap is narrower on the side of the knee that is hurting, then what I have described is likely to be correct. If this is the case, find out what you have to do to improve your left/right symmetry and do it. Yoga, Pilates or a visit to a good structural health professional for assessent would be a start. If the gap is even between both inner thighs and seat post is even or the pain is on the knee of the other side than what I have suggested, please get back to me for more advice.

Pain only in recommended fit range

I have a question concerning bike fit that I haven't seen directly addressed yet. I have been riding competitively since 1987. Almost exclusively on a MTB until I moved back to the city a few years ago and switched over to a road bike for obvious reasons. As a MTB rider I noticed how much lower road cyclists seats seemed to be in comparison to my MTB friends. I attributed this to the steep climbing involved with MTB riding, but that is pure speculation. I recently started seeing a Chiropractor, who through x-rays, showed me a slightly twisted pelvis. Treatments have helped considerably and I thought it a good time to get a professional fit. The fitter is well respected in our area and has worked with many cyclists I know.

As I expected, the process showed that I needed to lower my seat considerably. A lower seat seemed to give me a better balance of power all the way around my stroke. The problem is the muscles in my rear-end, along the outside and down to my knees to a lesser extent, hurt and cramp so bad that I can't stand to be in this position. I forced myself to try this position for a month to try and adapt but could not. Stretching doesn't help. If I get off the bike for 5 minutes after a 15 minute warm up it helps temporarily but not completely or permanently. The only thing that alleviates the discomfort is to raise my seat again about 1 ½ inches past what the fitter said was my maximum to stay within the normal fit guidelines. After doing this, all the pain goes away and I feel great.

My question is really this: Why do I seem to have so much discomfort at a recommended fit seat height? Are my IT bands too tight or could something else possibly be the cause? It seems that lowering my seat would help if any muscle group was too tight. I had my right ACL replaced with a hamstring graft, but this leg is no worse then the other and this doesn't seem to be the cause.

Justin Tomlinson

Steve Hogg replies

If you can't ride without the symptoms that you have described at the 'recommended seat height', then the seat height recommendation is wrong, at least in your case. Go back and see the bloke and calmly explain that you paid him money to do a job and that he hasn't done it well. If nothing else he will be forced to look at you as an individual rather than stick you in the appropriate leg length ' recommended seat height' box. This smacks of the ' do it by numbers ' approach to positioning.

When people start talking about "normal fit guide lines" get worried. Normal for who? Certainly not for people who pedal atypically, or for people who function differently to the 'norm'. There are plenty who do one or both. If you tried to ride the recommended height for a month and made no headway at all, the only problem is the recommendation, not the rider.
Raise your bars the 11/2 inches that it takes to relieve the pain, raise your bars the same amount and let me know what happens.
Re

Racing after a broken hip/leg

Hi, to cut along story short, I got hit by a car in June 2004. I had lots of nasty injuries, which I have recovered pretty well from. My question relates to my hip and leg. As a result of the accident I broke the head of my femur at the hip joint and broke my femur in two in the middle (all in the same leg). I now have a femoral nail down my right thigh, coming in at the top of the hip, going down to just above my knee.

I was keen to start racing in the 2005 season, but my surgeons strongly advised me against it. As apparently another heavy fall and break in the leg with the nail in would result in even more serious damage to my leg and an extended recovery of years, obviously not worth the risk for a weekend warrior for the sake of missing one season. However it's looking like I'm going to be keeping the pin for longer than I'd hoped, probably well into the start of the 2006 season. My question is what's the worst that could happen if I race and crash on this leg/hip. Are the risks really so great?

I imagine Joseba Beloki had similar treatment after his horrendous fall in the 2003 Tour. But he is still racing and I believe he still has the pin in his leg. I'm aware there's always the risk of crashing when I ride, but the likelihood is greater in road races. Also how long do you think I should give it after having the nail removed and starting riding and racing again? Thanks.

Matt Eastwood

Kelby Bethards replies

Matt,

That's a tough one. I know it's hard to resist the urge to start racing. Not everybody's bones are the same. Also, not every fracture is the same. Sounds like you had a pretty serious fracture. You are correct in assuming that Beloki had a bad fracture. However, he does this for a living and therefore is willing to incur the risks of re-fracture. His breaks may have also been more "fixable".

The risks of refracture are, but not limited to failure to heal the bone properly, additional, multiple surgeries and so on. If the bone is broken again and can't heal well, then you may end up requiring a lot of repairs, and eventually end up with a leg length discrepancy. Each time an operation is performed, there is a risk of infection, and bone infections are hard to heal. So, yes, the risks are real. It is likely that you would be ok in a crash, BUT, that is a risk you have to discuss with your Orthopedic surgeon(s) and decide the best timeframe for you to start racing again.

Stretching

Hi,

My son is just 10 and enjoys track cycling, competing with 12 year old kids at Newport Velodrome, Wales. He's only been doing it for a few months now, and I would be interested to know your thoughts; with children, how important are warm up stretches as there seems to be no culture of this in cycling here. It is taken that warming up with a gentle cycle for 10/15mins is sufficient. Also, what about stretching hamstrings etc afterwards, or is children's flexibility not a problem? Thanks in anticipation.

Mike Anstice

Newport, Wales

Jon Heidemann replies

Mike,

I imagine via your question, you will find experts with several differing opinions on stretching. While each will provide some evidence, whether through scientific study or direct experience, that argues their points, most coaches and athletic trainers will support stretching to maintain flexibility in regards to athletic performance and injury prevention. As a director of a junior cycling program here in the US, we stress that stretching in athletics, regardless of which sport, is important. Though children are generally more flexible than older athletes, they are not "immune" from issues related to inflexibility: athletic performance and injury prevention.

Our general routine is to cycle easy for about 10 15 minutes, then follow our "warm" stretching routine (we advise not to stretch "cold" muscles). Having "warmer" musculature seems to help get a deeper stretch with less soreness. Generally, the kids are usually not sore, but on occasions like the beginning of the season or for a new athlete, they may be experiencing some slight muscle soreness.

There are many great books on the market about stretching. One of the best we have found is a book by Bob Anderson called "Stretching" (http://www.stretching.com/). It contains sport specific stretching routines for before and after workouts as well as wonderful guidelines to use while stretching. Good luck.

Type II diabetes question

Hello Everyone,

I would appreciate your feedback on diabetes issues. I am a 55 year old male, 5'9", 215lbs., and a BMI of 28. I was diagnosed with Type II diabetes several years ago. I do weight training sporadically and cycling at the gym. My question is I would like to lose weight before I start road cycling. Please give me ideas on diet, how many calories before and after exercising and how long the exercise sessions should be. I would appreciate any tips or help you could offer. I have checked with my family doctor and he stated that he is not up-to-date on latest techniques. However, he is an avid cyclist and recommended your website. Thanks in advance.

Ralph Caccamo

Kelby Bethards replies

Ralph,

I will let the dieticians field your diet questions…but I wanted to suggest another thing you may need to consider.

Have you spoken with your MD about an exercise stress treadmill? I don't know how much cardio type workouts you do currently, but I would suggest you speak with your family doctor about having he/she do the stress test, if you don't do much cardio at present. The treadmill test helps us evaluated your heart under load, and we can observe the EKG changes that accompany that increased stress and hopefully tells us if it's safe for you to run your heart at "redline".

Upper calf/lower hamstring pain

I am a 31 year old male, 6'1'', and weigh 185 lbs. Last year I was a weekend rider going for 90-100 miles, but stopped riding once the weather turned cold. Through some convincing of a friend, I have decided to enter a race in Lake Tahoe (http://www.laketahoemarathon.com/Bike.html) and in June started to ride, perhaps, an aggressive training schedule. I rode 25 miles Tuesday, Wednesday, and Thursday morning at a medium/hard intensity, and 40-60 miles on weekend days. After several weeks, I started to develop pain in my upper calf, lower hamstring of my left leg.

I feel pain during the ride, but it becomes more evident after the ride, especially when I have to bend my leg to do something such as put on a pair of pants. Have you heard of something similar? I have read several articles, but nothing that seems to match my description. Any suggestions?

John Butorac

Steve Hogg replies

From what you say, it is very likely that you are overextending on that left leg. If you have a reasonable cleat and seat position, the hamstring and calf work together eccentrically to pull the knee backwards. This aids the quadriceps in extending the knee. However, if you are overextending pain can be the result in any of a number of areas including the one you are experiencing. Which one bites you depends on your own tendencies and proclivities.

First check the position of your foot over the pedal and make sure that you have the same relative position of foot in shoe over pedal. Note this is not necessarily the same thing as having the cleats in the same place on the sole of each shoe.

Next, when next on the bike, have a look at the gap between inner thigh and seat post. If the gap is larger on one side, then you are hanging to the other side and not sitting squarely on the seat. From what you have said, it is likely that you hang to the right [most people do to varying degrees] and that the gap will be larger between left inner thigh and seatpost.

If this is so, you then need to determine whether it is because your seat is a little too high forcing you to automatically make a choice about which side you will protect, or whether it is because of left/ right asymmetries of function in the hips and lower back. If you stretch regularly, you will already know whether you are noticeably tighter on one side or the other.

If you do find as I suspect that the gap is bigger between thigh and post on the left side, drop your seat 3 - 5 mm and see if that evens up the gap. If not, then you have some work to do in becoming more functionally symmetrical. If you need more info on this, just get back to me.

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